Monday, May 31, 2010
Apparently, hook worms occur in the ground naturally, especially when poor sanitation exists. They do not naturally occur in the United States because of our improved sanitation so he traveled abroad to inoculate himself because of severe allergies. He believed that hook worms naturally caused the immune system to be less reactionary, thereby controlling symptoms that are due to auto immune conditions. He also has shown that drug companies make products that do this but cost markedly more than hook worm inoculation and the hook worms are markedly safer. Apparently, as we evolved, we required hook worms in our system for our bodies to have a balanced immune system. Since our obsession with cleanliness and sanitation had gone to the extreme, we no longer contracted hook worms and therefore, we have seen an up tick of many autoimmune diseases processes which would have been kept in check with hook worms.
He has come under fire with the FDA but says the inoculation via skin contact with the live larvae who eventually live in our intestines are safe in low numbers and should be considered as a cost effective and natural/safe alternative to drug therapies.
Drug companies would have no incentive to develop such a treatment which could really cost at lease 90 percent less than the drug alternative. Personally, I believe that many problems we have in todays society have to do with similar processes that used to be in contact with us. Laetrile is one example of something we used to intake through seeds and pits which is no longer in our diets and evidence suggests it keeps cancer in check. Cancer rates in our society are skyrocketing and drug companies and hospitals like sloan kettering have no interest in low cost prevention/ alternatives because they are not good for their business model. Perhaps, we would be better off if truly non profit disease research would exist (it doesn't, even with the american cancer society) because we would find ways to keep people healthier and at lower cost, with better care. Technology is a double edged sword, and when private industry keeps the price high via patents and administration, of expensive technologies which have to pay themselves off, make a profit and pay their investors, perhaps we need to look outside the box of what we know to get the best answers.
What do you think. I value your opinion.
Sunday, May 30, 2010
Growth hormone may rise 300 percent with exercise: Acute increases also occur in cortisol, adrenaline, and noradrenaline
The hormonal and free fatty acid responses shown on the two graphs are to relatively intense exercise combining aerobic and anaerobic components. Something like competitive cross-country running in an area with hills would lead to that type of response. As you can see, cortisol spikes at the beginning, combining forces with adrenaline and noradrenaline (a.k.a. epinephrine and norepinephrine) to quickly increase circulating free fatty acid levels. Then free fatty acid levels are maintained elevated by adrenaline, noradrenaline, and growth hormone. As you can see from the graphs, free fatty acid levels are initially pulled up by cortisol, and then are very strongly correlated with adrenaline and noradrenaline. Those free fatty acids feed muscle, and also lead to the production of ketones, which provide extra fuel for muscle tissue.
Growth hormone stays flat for about 40 minutes, after which it goes up steeply. At around the 90-minute mark, it reaches a level that is quite high; 300 percent higher than it was prior to the exercise session. Natural elevation of circulating growth hormone through intense exercise, intermittent fasting, and restful sleep, leads to a number of health benefits. It helps burn abdominal fat, often hours after the exercise session, and helps builds muscle (in conjunction with other hormones, such as testosterone). It appears to increase insulin sensitivity in the long run. Maybe natural elevation of circulating growth hormone is one of the “secrets” of people like Bob Delmonteque, who is probably the fittest octogenarian in the world today.
Aerobic activities normally do not elevate growth hormone levels, even though they are healthy, unless they lead to a significant degree of glycogen depletion. Glycogen is stored in the liver and muscle, with muscle storing about 5 times more than the liver (about 500 g in adults). Once those reserves go down significantly during exercise, it seems that growth hormone is recruited to ramp up fat catabolism and facilitate other metabolic processes. Walking for an hour, even if briskly, is good for fat burning, but generates only a small growth hormone elevation. Including a few all-out sprints into that walk can help significantly increase growth hormone secretion.
Having said that, it is not really clear whether growth hormone elevation is a response to glycogen depletion, or whether both happen together in response to another stimulus or related metabolic process. There are other factors that come into play as well. For example, circulating growth hormone increase is moderated by sex hormone (e.g., testosterone, estrogen) secretion, thus larger growth hormone increases in response to exercise are observed in older men than in older women. (Testosterone declines more slowly with age in men than estrogen does in women.) Also, growth hormone increase seems to be correlated with an increase in circulating ketones.
Heavy resistance exercise seems to lead to a higher growth hormone elevation per unit of time than endurance exercise. That is, an intense resistance training session lasting only 30 minutes can lead to an acute circulating growth hormone response, similar to that shown on the figure. The key seems to be reaching the point during the exercise where muscle glycogen stores are significantly depleted. Many people who weight-train achieve this regularly by combining a reasonable number of sets (e.g., 6-12), with repetitions in the muscle hypertrophy range (again, 6-12); and progressive overload, whereby resistance is increased incrementally every session.
Progressive overload is needed because glycogen reserves are themselves increased in response to training, so one has to increase resistance every session to keep up with those increases. This goes on only up to a point, a point of saturation, usually reached by elite athletes. Glycogen is the primary fuel for anaerobic exercise; fat is used as fuel in the recovery period between sets, and after the exercise is over. Glycogen is expended proportionally to the number of calories used in the anaerobic effort. Calories are expended proportionally to the total amount of weight moved around, and are also a function of the movements performed (moving a certain weight 1 feet spends less energy than moving it 3 feet). By the way, not much glycogen is depleted in a 30-minute session. The total caloric expenditure will probably be around 250 calories above the basal metabolic rate, which will require about 63 g of glycogen.
Many sensations are associated with reaching the glycogen depletion level required for an acute growth hormone response during heavy anaerobic exercise. Often light to severe nausea is experienced. Many people report a “funny” feeling, which is unmistakable to them, but very difficult to describe. In some people the “funny” feeling is followed, after even more exertion, by a progressively strong sensation of “pins and needles”, which, unlike that associated with a heart attack, comes slowly and also goes away slowly with rest. Some people feel lightheaded as well.
It seems that the optimal point is reached immediately before the above sensations become bothersome; perhaps at the onset of the “funny” feeling. My personal impression is that the level at which one experiences the “pins and needles” sensation should be avoided, because that is a point where your body is about to “force” you to stop exercising. (Note: I am not a bodybuilder; see “Interesting links” for more extensive resources on the subject.) Besides, go to that point or beyond and significant muscle catabolism may occur, because the body prioritizes glycogen reserves over muscle protein. It will break that protein down to produce glucose via gluconeogenesis to feed muscle glycogenesis.
That the body prioritizes muscle glycogen reserves over muscle protein is surprising to many, but makes evolutionary sense. In our evolutionary past, there were no selection pressures on humans to win bodybuilding tournaments. For our hominid ancestors, it was more important to have the glycogen tank at least half-full than to have some extra muscle protein. Without glycogen, the violent muscle contractions needed for a “fight or flight” response to an animal attack simply cannot happen. And large predators (e.g., a bear) would not feel intimated by big human muscles alone; it would be the human’s response using those muscles that would result in survival or death.
Overall, selection pressures probably favored functional strength combined with endurance, leading to body types similar to those of the hunter-gatherers shown on this post.
Even though the growth hormone response to exercise can be steep, the highest natural growth hormone spike seems to be the one that occurs at night, during deep sleep.
Exercising hard pays off, but only if one sleeps well.
Wilmore, J.H., Costill, D.L., & Kenney, W.L. (2007). Physiology of sport and exercise. Champaign, IL: Human Kinetics.
Saturday, May 29, 2010
The latest study to fall into this myth was published in the AJCN recently (1). Investigators showed that 1/3 bottle of red wine per day for 21 days increased blood flow in forearm vessels of healthy volunteers, which they interpreted as "enhanced vascular endothelial function"*. The novel finding in this paper is that red wine consumption increases the migration of certain cells into blood vessels that are thought to maintain and repair the vessels. There were no control groups for comparison, neither abstainers nor a group drinking a different type of alcohol.
The investigators then went on to speculate that the various antioxidant polyphenols in red wine, such as the trendy molecule resveratrol, could be involved. Even though you have to give animals 500 bottles' worth of resveratrol per day to see any effect. But there's another little problem with this hypothesis...
Ethanol-- plain old alcohol. You could drink a 40 oz bottle of malt liquor every night and it would probably do the exact same thing.
No matter what the source, alcohol consumption is associated with a lower risk of cardiovascular disease out to about 3-4 drinks per day, after which the risk goes back up (2, 3)**. The association is not trivial-- up to a 62% lower risk associated with alcohol use. Controlled trials have shown that alcohol, regardless of the source, increases HDL cholesterol and reduces the tendency to clot (4).
Should we all start downing three drinks a day? Not so fast. Although alcohol does probably decrease heart attack risk, the effect on total mortality is equivocal. That's because it increases the risk of cancers and accidents. Alcohol is a drug, and my opinion is that like all drugs, overall it will not benefit the health of a person with an otherwise good diet and lifestyle. That being said, it's enjoyable, so I have no problem with drinking it in moderation. Just don't think you're doing it for your health.
So does red wine decrease the risk of having a heart attack? Yes, just as effectively as malt liquor. It's not the antioxidants and resveratrol, it's the ethanol. The reason the French avoid heart attacks is not because of some fancy compound in their wine that protects them from a high saturated fat intake. It's because they have preserved their diet traditions to a greater degree than most industrialized nations.
I do think it's interesting to speculate about why alcohol (probably) reduces heart attack risk. As far as I know, the mechanism is unknown. Could it be because it relaxes us? I'm going to ponder that over a glass of whiskey...
* It may well represent an improvement of endothelial function, but that's an assumption on the part of the investigators. It belongs in the discussion section, if anywhere, and not in the results section.
** The first study is really interesting. For once, I see no evidence of "healthy user bias". Rates of healthy behaviors were virtually identical across quintiles of alcohol intake. This gives me a much higher degree of confidence in the results.
Friday, May 28, 2010
One year later after my new doctor (I told the doctor who diagnosed me that I was taking a hike after that whole incident!) reviewed my bone density scan, he smiled and said, “What have you been doing?! The scan is no different than last years which means whatever you’re doing is working, preventing any further bone loss. Keep it up!” He was happy (and impressed) to hear what I had been doing to keep my bones strong. Also, during a teeth cleaning, my dentist commented on how strong and healthy my teeth were looking. One of the first places a doctor can see deterioration or weakness in the bones is in the teeth.
This was all very good news and I have continued with caring for my bones as such. I have faith that my bone scan this month will be similar to last years. Since now I’m a Metagenics rep, I have been taking a high quality calcium supplement, along with a high does of vitamin D3 to ensure absorption. If you would like more information on Metagenics, or would like to order any products, feel free to contact me at email@example.com
...Now, onto the information to help YOUR bones!
Calcium is a mineral needed by the body for healthy bones, teeth, and proper function of the heart, muscles, and nerves. The body cannot produce calcium; therefore, it must be absorbed through food. Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.
Getting the calcium and vitamin D you need is easier than you think -- if you eat the right foods. Because of heavy promotion by the American dairy industry, the public often believes that cow's milk is the sole source of calcium. However, other excellent sources of calcium exist in a variety of different forms. You have to remember that the dairy industry’s number one goal is to sell more dairy products! The truth is that dairy products have been linked to a laundry list of diseases, ailments and increased bone loss. And, while dairy products do contain a lot of calcium, they also contain a lot of protein, which in turn leeches calcium away from the bones.
Keep in mind that excessive alcohol, caffeine, protein, salt and sugar deplete calcium or interfere with calcium absorption. To improve bone health, you should focus on a balanced diet including calcium-rich foods (below) and avoid prepackaged processed foods.
Good sources of calcium (that do NOT come from a cow) include:
Dark Leafy Greens:
Swiss Chard Kale
Nuts & Seeds:
Tahini (sesame seed butter)
Other Foods High in Calcium:
As you can see, eating a varied diet rich in dark leafy greens, fruit, nuts, and seeds will give you plenty of calcium and you'll get so many other health benefits from these foods as well!
Don’t Forget Your Vitamin D!
Vitamin D is necessary in helping the body absorb calcium. Sunlight is the best source of this vitamin. When the weather permits, try to make it a point to get at least 10-15 minutes of natural sunlight (with NO sunscreen) each day. Make this gesture as important as anything else in your schedule, because it is! Use it as an excuse to get outside for a bit (make a phone call, take a breather, walk around the building, take the dog for a walk, etc.). Another good way to know that you are getting vitamin D is by choosing organic, free-range dairy and/or animal products. Animals that were able to roam freely, in the natural sunlight, were able to absorb vitamin D which then will be in the food you consume.
Are YOU Calcium Deficient?
If you have a calcium deficiency, you may develop twitching, nerve sensitivity, brittle nails, insomnia, depression, numbness, and heart palpitations. My calcium deficiency was through my brittle, flaky nails. For years my nails were so brittle, little did I know it was a sign from my body saying to feed it calcium rich foods and get moving!
Do you get enough calcium? What non-dairy sources do you include in your diet?
Keep it fresh!
Thursday, May 27, 2010
Postprandial glucose levels, HbA1c, and arterial stiffness: Compared to glucose, lipids are not even on the radar screen
HbA1c, or glycated hemoglobin, is a measure of average blood glucose over a period of a few months. Blood glucose glycates (i.e., sticks to) hemoglobin, a protein found in red blood cells. Red blood cells are relatively long-lived, lasting approximately 3 months. Thus HbA1c (given in percentages) is a good indicator of average blood glucose levels, if you don’t suffer from anemia or a few other blood abnormalities.
Based on HbA1c, one can then estimate his or her average blood glucose level for the previous 3 months or so before the test, using one of the following equations, depending on whether the measurement is in mg/dl or mmol/l.
Average blood glucose (mg/dl) = 28.7 × HbA1c − 46.7
Average blood glucose (mmol/l) = 1.59 × HbA1c − 2.59
Elevated blood glucose levels cause damage in the body primarily through glycation, which leads to the formation of advanced glycation endproducts (AGEs). Given this, HbA1c can be seen as a proxy for the level of damage done by elevated blood glucose levels to various body tissues. This damage occurs over time; often after many years of high blood glucose levels. It includes kidney damage, neurological damage, cardiovascular damage, and damage to the retina.
Most regular blood exams focus on fasting blood glucose as a measure of glucose metabolism status. Many medical practitioners have as a target a fasting blood glucose level of 125 mg/dl (7 mmol/l) or less, and largely disregard postprandial glucose levels or HbA1c in their management of glucose metabolism. Leiter and colleagues (2005; full reference at the end of this post) showed that this focus on fasting blood glucose is a mistake. They are not alone; many others made this point, including some very knowledgeable bloggers who focus on diabetes (see “Interesting links” section of this blog). Leiter and colleagues (2005) also provided some interesting graphs and figures, including eye-opening correlations between various variables and arterial stiffness. The figure below (click to enlarge) shows the contribution of postprandial glucose to HbA1c.
Note that the lower the HbA1c is in the figure (horizontal axis), the higher is the postprandial glucose contribution to HbA1c. And, the lower the HbA1c, the closer the individuals are to what one could consider having a perfectly normal HbA1c level (around 5 percent). That is, only for individuals whose HbA1c levels are very high, fasting blood glucose levels are relatively reliable measures of the tissue damage done be elevated blood glucose levels.
The table below (click to enlarge) shows P values associated with the impact of various variables (listed on the leftmost column) on arterial stiffness. This measure, arterial stiffness, is strongly associated with an increased risk of cardiovascular events. Look at the middle column showing P values adjusted for age and height. The lower the P value, the more a variable affects arterial stiffness. The variable with the lowest P value by far is 2-hour postprandial blood glucose; the blood glucose levels measured 2 hours after meals.
Fasting glucose levels were reported to be statistically insignificant because of the P = 0.049, in terms of their effect on arterial stiffness, but this P value is actually significant, although barely, at the 0.05 level (95 percent confidence). Interestingly, the following measures are not even on the radar screen, as far as arterial stiffness is concerned: systolic blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, and fasting insulin levels.
What about the lipid hypothesis, and the “bad” LDL cholesterol!? This study is telling us that these are not very relevant for arterial stiffness when we control for the effect of blood glucose measures. Not even fasting insulin levels matters much! Wait, not even HDL!!! A high HDL has been definitely shown to be protective, but when we look at the relative magnitude of various effects, the story is a bit different. A high HDL’s protective effect exists, but it is dwarfed by the negative effect of high blood glucose levels, especially after meals, in the context of cardiovascular disease.
What all this points at is what we could call a postprandial glucose hypothesis: Lower your postprandial glucose levels, and live a longer, healthier life! And, by the way, if your postprandial glucose levels are under control, lipids do not matter much! Or maybe your lipids will fall into place, without any need for statin drugs, after your postprandial glucose levels are under control. One way or another, the outcome will be a positive one. That is what the data from this study is telling us.
How do you lower your postprandial glucose levels?
A good way to start is to remove foods rich in refined carbohydrates and sugars from your diet. Almost all of these are foods engineered by humans with the goal of being addictive; they usually come in boxes and brightly colored plastic wraps. They are not hard to miss. They are typically in the central aisles of supermarkets. The sooner you remove them from your diet, the better. The more completely you do this, the better.
Note that the evidence discussed in this post is in connection with blood glucose levels, not glucose metabolism per se. If you have impaired glucose metabolism (e.g., diabetes type 2), you can still avoid a lot of problems if you effectively control your blood glucose levels. You may have to be a bit more aggressive, adding low carbohydrate dieting (as in the Atkins or Optimal diets) to the removal of refined carbohydrates and sugars from your diet; the latter is in many ways similar to adopting a Paleolithic diet. You may have to take some drugs, such as Metformin (a.k.a. Glucophage). But you are certainly not doomed if you are diabetic.
Leiter, L.A., Ceriello, A., Davidson, J.A., Hanefeld, M., Monnier, L., Owens, D.R., Tajima, N., & Tuomilehto, J. (2005). Postprandial glucose regulation: New data and new implications. Clinical Therapeutics, 27(2), S42-S56.
Get out there and shake that pregnant ass!! You heard me, you're a beautiful life creating goddess, now shake it!
Exercise is such an important part of staying healthy during your pregnancy. It will boost your energy, help you sleep better, reduce discomfort, improve your self image and reduce stress and uplift your spirits.
If that's not already a win-win situation add these two zingers to the mix and you won't be able to say no!
First, exercise during pregnancy will prepare you for child birth. Child birth is hard, some equate it to running a marathon. The better shape your in during your pregnancy, the "easier" childbirth will be. The American Academy of Orthopedic Surgeons in a recent news release stated "Women who are expecting can benefit greatly from exercise especially yoga." Training for childbirth through yoga may ease labor and even shorten the time it takes to deliver your baby.
Secondly, exercise during your pregnancy will help you get that pre-pregnancy body back after birth....the same one that got you knocked up to begin with! Though yoga and other exercise you will maintain your strength and muscle tone throughout pregnancy allowing you body to bounce back easier after you give birth. This alone may be motivation enough for most women to start a pregnancy exercise regimen.
Whether you're new to yoga or other exercise or you're a fit pro, here are some tips for prenatal exercise:
Interested in prenatal yoga? Stay tuned in to 3 Healthy Chicks Keeping it Fresh for more on the benefits of prenatal yoga and incorporating prenatal yoga into your daily routine. Or join me on Tuesday mornings at10:30am The Yoga and Healing Center in Scotch Plains for Wise Mamas Prenatal Yoga!
Keep it Fresh!
Wednesday, May 26, 2010
It's no secret that a regular yoga practice tones, lengthens muscles and increases stamina, I am not letting the cat out of the bag here. The experienced yoga practitioner tests their flexibility with pretzel like asanas, such as dwi pada srisasana (feet behind the head pose), ananda balasana (happy baby pose) and supta kurmasana (reclining tortoise pose). While the point of yoga isn't to tie yourself into knots, it's easy to associate yoga with the work of contortionists. My yoga teacher likes to call those such poses her "yoga party tricks." Don't worry, in this blog post we won't take our yoga party tricks on the road, we save for the bedroom.
Yoga and sex are easily married. They are both physical and emotional, challenging and uplifting, they both use the body to calm the mind and uplift the spirit and they're both great for the immune system (did you know that orgasms improve the immune system?). If you can think of one amazing and fulfilling yoga class that took, it probably included physical agility, sweat, an elevated heart rate, mental clarity and spiritual openness. The perfect yoga class is a sacred experience. Now think about the last time you had great sex. Every fulfilling sexual union relies on the same characteristics. It's simply up to you and your partner to orchestrate it. When you start thinking about sexual contact and sexual energy as sacred, the act of sex begins to shift. Bringing increased awareness and sensitivity into each sexual experience will not only enhance your pleasure, but bring a closer connection to your partner.
"Yoga focuses people on how they feel, which is something they don't do enough during sex," says Dr. Marty Klein, a sex therapist and author of Beyond Orgasm: Dare to be Honest about the Sex You Really Want. "During sex, people tend to think more about what they imagine the other person is looking at or thinking about. Yoga brings the mind away from judgments, thoughts, speculations, assumptions, anxieties - things that interfere with physical response and emotional satisfaction."
The style of yoga doesn't matter. Whether you practice, gentle hatha, vinyasa flow, Kundalini, Jivamukti or Soul Sweat Asana, a consistent practice will bring greater awareness to your body and and who you choose to get physical with. The more in tune and receptive you are to your own body, the more in tune and receptive you will be to your partner. This receptiveness will help you recognize the shifts in energy your partner has and tune into what feels good and what feels great for each of you. Add communication to the mix and you'll be on your way to becoming a sexpot in the bedroom and living a life that includes supersatisfying sex!
(the list is close to endless, but this post is getting long, I decided to cap it at 5).
Awareness: A consistent yoga practice brings awareness. Awareness to your own body and those around you. VAKGO is a theory my yoga teacher learned and taught me. It's an acronym that stands for Visual, Auditory, Kinestetic, Gustatory and Olfactory. Fancy names for seeing, hearing, feeling (emotions and tactile), tasting and smelling. All real experiences contain these five elements. Yoga helps the practitioner step into VAKGO and living in the moment. This awareness and ability to be in the moment is essential for great sex.
Yogic Philosophy: The Yoga Sutras of Patanjali teach the Yamas and Niyamas, the "dos and don'ts" of living a yogic life. While each of these can be applicable to the yoga of great sex, the first principal (Yama), Ahimsa may be most applicable. Ahimsa translates roughly to non-violence or compassion. It is non-violence and compassion first and foremost to yourself. Bringing ahimsa into the bedroom will allow you to let go of judgment and simply enjoy an uninhibited good time. Remember, he's not watching the cellulite on your ass jiggle, thinking you need to lose a few pounds. He's thinking, OMG I am getting a piece of ass!!!
Bandhas: Bandhas are energy locks in the body. We have 3: Mula Bandha (pelvic floor or root lock), Uddiyana Bandha (solar plexus or abdominal lock) and Jhalandara Bandha (throat or throat lock). Learning to engage your bandhas during your asana practice cleanses and energizes the interior body. Mula Bandha is for both women and men. Engaging mula bandha (which is much like doing a kegel for women or trying to stop the flow of urine while going to the bathroom for men) builds strength in the pelvic floor and improves blood flow and circulation. Blood flow and circulation in the genitals is essential for sexual arousal and orgasm.
Asana: This seems like a no brainer here. Yoga party tricks! Regular asana practice will build energy, stamina, strength and flexibility. Just as there are many asana's out there, there are just as many sexual positions. Have you thumbed through the Karma Sutras? But while there are lots of positions out there, you can't get into them with a tight, stiff body.
Pranayama: Pranayama is yogic breath work or breath control. Yoga teaches that breath is life. Proper breathing bring more oxygen and blood to the brain and helps to harness prana, our life force energy. The practice of Tantric (Tantra meaning two woven together, or two fullness as one) Yoga or tantric sex teaches that though the joining of two spiritual bodies the two poles can be ecstatically merged to reach enlightenment or bliss. This is accomplished through the connection of energy and breath. We don't have to turn into tantric practitioners to use pranayama for great sex. Simply gazing into our partners eyes and breathing together will create a deeper emotional connection. Slowing the breath and using control will increase sexual arousal help to prolong orgasm.
So there you have it. Now go forth, practice yoga and have great sex!!
Keep it Fresh!
The saturated fat is good for you. The omega-6-to-omega-3 ratio is not a great one, but a 100 g portion will have a small absolute amount of omega-6 fats, which can be easily offset with some omega-3 from seafood or a small amount of fish oil. Pork tenderloin is easy to find in supermarkets, and is much less expensive than filet mignon, even though it is a relatively expensive cut of meat.
Below are the before and after photos of a roasted pork tenderloin we prepared and ate recently; a simple recipe follows the photos. This type of cooking leads to a Maillard reaction, which is clear from the browning of the meat and around it on the casserole. I am not too concerned; more about this after the recipe.
Below is the simple recipe. The roasted pork pieces come off easily after the roasting is done, and almost melt in the mouth!
- Make about 10 holes on 2 lbs of pork tenderloin, and add chopped garlic pieces into each of them.
- Pour about a cup of salsa evenly over the pork tenderloin pieces.
- Cover roasting container (casserole in photos) with aluminum foil to preserve moisture.
- Preheat over to 375 degrees Fahrenheit.
- Roast the pork tenderloin for about 3 hours.
Now back to the Maillard reaction. When it happens inside the body, it is a step in the formation of advanced glycation endproducts (AGEs), which is not very good, as AGEs are believed to cause accelerated aging. However, the evidence that cooked meat is unhealthy, in the absence of leaky gut problems, is very slim. There are many hypothesized causes of the leaky gut syndrome, one of which is consumption of refined wheat products.
Our Paleolithic ancestors must have eaten charred meat on a regular basis, so it does not make much evolutionary sense to think that eating roasted meat leads to accelerated aging through the ingestion of AGEs. It is possible that eating charred meat caused health problems for our ancestors, and they threw their meat in the fire and then ate it charred anyway. Perhaps the health problems caused by charring were offset by the benefits of killing parasites living in meat with the heat of fire.
This is an open issue that needs much more research. Based on most of the research I have seen so far, eating roasted meat is not even in the same universe, in terms of the health problems that it can possibly generate, as is eating foods rich in refined carbohydrates and sugars (e.g., white bread, bagels, pasta, and non-diet sodas).
Tuesday, May 25, 2010
I'm currently reading a great book edited by Drs. Hugh Trowell and Denis Burkitt, titled Western Diseases: Their Emergence and Prevention. It's a compilation of chapters describing the diet and health of traditional populations around the world as they modernize.
The book contains a chapter on Papua New Guinea highlanders. Here's a description of their diet:
A diet survey was undertaken involving 90 subjects, in which all food consumed by each individual was weighed over a period of seven consecutive days. Sweet potato supplied over 90 percent of their total food intake, while non-tuberous vegetables accounted for less than 5 percent of the food consumed and the intake of meat was negligible... Extensive herds of pigs are maintained and, during exchange ceremonies, large amounts of pork are consumed.They ate no salt. Their calories were almost entirely supplied by sweet potatoes, with occasional feasts on pork.
How was their health? Like many non-industrial societies, they had a high infant/child mortality rate, such that 43 percent of children died before growing old enough to marry. Surprisingly, protein deficiency was rare. No obvious malnutrition was observed in this population, although iodine-deficiency cretinism occurs in some highlands populations:
Young adults were well built and physically fit and had normal levels of haemoglobin and serum albumin. Further, adult females showed no evidence of malnutrition in spite of the demands by repeated cycles of pregnancy and lactation. On the basis of American standards (Society of Actuaries, 1959), both sexes were close to 100 percent standard weight in their twenties.
The Harvard Pack Test carried out on 152 consecutive subjects demonstrated a high level of physical fitness which was maintained well into middle-age. Use of a bicycle ergometer gave an estimated maximum oxygen uptake of 45.2 ml per kilogram per minute and thus confirmed the high level of cardiopulmonary fitness in this group.Body weight decreased with age, which is typical of many non-industrial cultures and reflects declining muscle mass but continued leanness.
There was no evidence of coronary heart disease or diabetes. Average blood pressure was on the high side, but did not increase with age. Investigators administered 100 gram glucose tolerance tests and only 3.8 percent of the population had glucose readings above 160 mg/dL, compared to 21 percent of Americans. A study of 7,512 Papuans from several regions with minimal European contact indicated a diabetes prevalence of 0.1 percent, a strikingly low rate. For comparison, in 2007, 10.7 percent of American adults had diabetes (1).
I'm not claiming it's optimal to eat nothing but sweet potatoes. But this is the strongest evidence we're going to come by that sweet potatoes can be eaten in quantity as part of a healthy diet. However, I wish I knew more about the varieties this group ate. Sweet potatoes aren't necessarily sweet. Caribbean 'boniato' sweet potatoes are dry, starchy and off-white. In the US, I prefer the yellow sweet potatoes to the orange variety of sweet potato labeled 'yams', because the former are starchier and less sweet. If I could get my hands on locally grown boniatos here, I'd eat those, but boniatos are decidedly tropical.
Instead, I eat potatoes, but I'm reluctant to recommend them whole-heartedly because I don't know enough about the traditional cultures that consumed them. I believe there are some low-CHD, low-obesity African populations that eat potatoes as part of a starch-based diet, but I haven't looked into it closely enough to make any broad statements. Potatoes have some nutritional advantages over sweet potatoes (higher protein content, better amino acid profile), but also some disadvantages (lower fiber, lower in most micronutrients, toxic glycoalkaloids).
Monday, May 24, 2010
I was quite upset by what I saw because many of the increases we see each year from our health insurance carriers is because of never ending procedures and aimless care. I was able to help her today and she walked out of the office more easily and in less pain. The problem is that I am seeing this with increasing frequency. As your chiropractor, I see myself as part of a persons health care team, however, in many ways I am also primary care for the musculoskeletal system. I look at people, not just their symptoms. In this womans case, they looked at symptoms, and somehow forgot that everything is connected. I suspect this is because of our broken healthcare paradigm, which is proliferated at is source, the educational institutions that teach broken care full of big words, with little understanding behind them.
I firmly believe we need to make primary care to be more important that specialization, and we need to teach doctors about body systems. By looking at the knees, hips, arms and other painful areas, and ignoring their inter relationships, we are harming people and at worst, ripping off the public. The public deserves better.
If you know of someone who is experiencing this type of situation, and they have not looked outside the traditional medical system, perhaps they need to place their trust elsewhere. Doing the same thing and expecting a different result is the definition of insanity. I would be happy to help this person and steer them in the right direction.
The best doctors treat people, rather than the symptoms they'd shown up with.
What do you think? I value your opinions.
Natural foods are not designed to make you eat them nonstop. Animals do not want to be eaten (even these odd-looking birds below). Most plants do not “want” their various nutritious parts to be eaten. Fruits are exceptions, but plants do not want one single individual to eat all their fruits. That compromises seed dispersion. Multiple individual fruit eaters enhance seed dispersion. Plants "want" one individual animal to eat some of their fruits and then move on, so that other individuals can also eat.
It is safe to assume that doughnut manufacturers want one single individual to eat as many doughnuts as possible, and many individuals to want to do that. That takes some serious food engineering, and a lot of testing. Success will increase the manufacturers' revenues, the real bottom line for them. The medical establishment will then take care of those individuals, and prolong their miserable lives so that they can continue eating doughnuts for as long as possible. It is self-perpetuating system.
As mentioned in this previous post, to succeed in the practice of intermittent fasting, one has to stop worrying about food, and one good step in that direction is to avoid engineered foods. In this sense, intermittent fasting can be seen as a form of liberation. Doing something enjoyable and forgetting about food. Like children playing outdoors; they do not care as much about food as they do about play. Even sleeping will do; most people forget about eating when they are asleep.
Intermittent fasting as a religious and/or social activity, as in the Great Lent and Ramadan, also seems to work well. Any activity that brings people together with a common goal, especially if the goal is not to do something evil, has a lot of potential for success.
If you approach intermittent fasting as another thing to worry about, then it will be tough – one fast per week, on the same day of the week, from 7.33 pm of one day to 3.17 pm of the next day. I exaggerate a bit. Anyway, if you approach it as another obligation, another modern stressor, you will probably fail in the medium to long term. It is just commonsense. Maybe you will be able to do it for a while, but not for long enough to reap some serious benefits. A few fasts are not going to make you lose a lot of weight; the body will adapt in a compensatory way during the fast, slowing down your metabolism a bit and conserving calories. On top of that, you will feel very, very hungry. That will make you binge when you break your fast. Compensatory adaptation (a very general phenomenon) is something that our body is very good at, regardless of what we want it to do.
From a more pragmatic perspective, for most people it is easier to fast at night and in the morning. Eating a big meal right after you wake up is not a very natural activity; several hormones that promote body fat catabolism are often elevated in the morning, causing mild physiological insulin resistance.
If you have dinner at 7 pm, skip breakfast, and then have brunch the next day at 10 am, you will have fasted for 15 h. If you skip breakfast and brunch, and have lunch at noon the next day, you will have fasted for 17 h.
On the other hand, if you have breakfast at 8 am, skip lunch, and then have dinner at 6 pm, you will have fasted only for 10 h.
Leptin levels seem to go down significantly after 12 h of fasting, leading to increased body fat catabolism and leptin sensitivity. This is a good thing, since leptin resistance seems to frequently precede insulin resistance.
Many people think that skipping breakfast will make them fat, for various reasons, including that being what sumo wrestlers do to put on enormous amounts of body fat. Well, skipping breakfast probably will make people fat if, when they break the fast, they stuff themselves to the point of almost throwing up, combine plenty of easily digestible carbohydrates (e.g., multiple bowls of rice) with a lot of dietary fat, and then go to sleep. That is what sumo wrestlers normally do.
Eating fat is great, but not together with lots of easily digestible carbohydrates. Even eating a lot of fat by itself will make it difficult for you to shed enough fat to look like the hunter-gatherers in this post. But your body fat set point will be much lower if you eat a lot of fat by itself than if you eat a lot of fat with a lot of easily digestible carbohydrates.
Anyway, if people skip breakfast and eat what they normally eat at lunch, they will not gain more body fat than they would have if they had breakfast. If they do anything to boost their metabolism in the morning, they will most certainly lose body fat in a noticeable way over several weeks, as long as they have enough fat to lose. For example, they can add some light activity in the morning (such as walking), or have a metabolism-boosting drink (e.g., coffee, green tea), or both.
Our hunter-gatherer ancestors, living outdoors, probably spent most of their day performing light activities that involved little stress. Those activities increase metabolism and fat burning, while keeping stress hormone levels at low ranges. Hunger suppression was the result, making intermittent fasting fairly easy.
Again, intermittent fasting should be approached as a form of liberation. You are no longer a slave of food.
It helps staying away from engineered foods as much as possible, because, again, they are usually engineered with food addiction in mind. I am talking primarily about foods rich in refined carbohydrates and sugars. They come in boxes and plastic bags with labels describing calories and macronutrient composition, which are often wrong or misleading.
Let us say we could transport a group of archaic Homo sapiens to a modern city, and feed them white bread, bagels, doughnuts, potato chips industrially fried in vegetable oils, and the like. Would they say “Yuck, how can these people eat this?” No, they would not. It would be heaven for them; they would want nothing else for the rest of their gustatorily happy but health-wise miserable lives.
While practicing intermittent fasting, it is probably a good idea to have fixed meal times, and skipping them from time to time. The reason is the hunger hormone ghrelin, secreted by the stomach (mostly) and pancreas to stimulate hunger and possibly prepare the digestive tract for optimal or quasi-optimal absorption of food. Its secretion appears to follow the pattern of habitual meals adopted by a person.
Elliott, W.H., & Elliott, D.C. (2009). Biochemistry and molecular biology. 4th Edition. New York: NY: Oxford University Press.
Fuhrman, J., & Barnard, N.D. (1995). Fasting and eating for health: A medical doctor's program for conquering disease. New York, NY: St. Martin’s Press.
Saturday, May 22, 2010
Cows grazing pasture and receiving no supplemental feed had 500% more conjugated linoleic acid in milk fat than cows fed typical dairy diets.Fat from ruminants such as cows, sheep and goats is the main source of CLA in the human diet. CLA is fat-soluble. Therefore, skim milk doesn't contain any. It's also present in human body fat in proportion to dietary intake. This can come from dairy or flesh.
In a recent article from the AJCN, Dr. Liesbeth Smit and colleagues examined the level of CLA in the body fat of Costa Rican adults who had suffered a heart attack, and compared it to another group who had not (a case-control study, for the aficionados). People with the highest level of CLA in their body fat were 49% less likely to have had a heart attack, compared to those with the lowest level (2).
Since dairy was the main source of CLA in this population, the association between CLA and heart attack risk is inextricable from the other components in pastured dairy fat. In other words, CLA is simply a marker of pastured dairy fat intake in this population, and the (possible) benefit could just as easily have come from vitamin K2 or something else in the fat.
This study isn't the first one to suggest that pastured dairy fat may be uniquely protective. The Rotterdam and EPIC studies found that a higher vitamin K2 intake is associated with a lower risk of heart attack, cancer and overall mortality (3, 4, 5). In the 1940s, Dr. Weston Price estimated that pastured dairy contains up to 50 times more vitamin K2 than grain-fed dairy. He summarized his findings in the classic book Nutrition and Physical Degeneration. This finding has not been repeated in recent times, but I have a little hunch that may change soon...
Cardiovascular Disease and Vitamin K2
Can Vitamin K2 Reverse Arterial Calcification?
Friday, May 21, 2010
Our Paleolithic ancestors were likely very spiritual people; at least those belonging to the Homo sapiens species. Earlier ancestors, such as the Australopithecines, may have lacked enough intelligence to be spiritual. Interestingly, often atheism is associated with high intelligence and a deep understanding of science. Many well-known, and brilliant, evolution researchers are atheists (e.g., Richard Dawkins).
Well, when we look at our ancestors, spirituality seems to have emerged as a result of increased intelligence.
Spirituality can be seen in cave paintings, such as the one below, from the Chauvet Cave in southern France. The Chauvet Cave is believed to have the earliest known cave paintings, dating back to about 30 to 40 thousand years ago. The painting below is on the cover of the book Dawn of art: The Chauvet Cave. (See the full reference for this publication and others at the end of this post.)
The most widely accepted theory of the origin of cave paintings is that they were used in shamanic or religious rituals. By and large, they were not used to convey information (e.g., as maps); and they are often found deep in caves, in areas that are almost inaccessible, ruling out a “decorative” artistic purpose. As De La Croix and colleagues (1991) note:
Researchers have evidence that the hunters in the caves, perhaps in a frenzy stimulated by magical rites and dances, treated the painted animals as if they were alive. Not only was the quarry often painted as pierced by arrows, but hunters actually may have thrown spears at the images, as sharp gouges in the side of the bison at Niaux suggest.Niaux is another cave in southern France. Like the Chauvet Cave, it is full of prehistoric paintings. Even though those paintings are believed to be more recent, dating back to the end of the Paleolithic, they follow the same patterns seen almost everywhere in prehistoric art. The patterns point at a life that gravitates around spiritual rituals.
Isolated hunter-gatherers also provide a glimpse at our spiritual Paleolithic past. No isolated hunter-gatherer group has ever been found in which atheism was the predominant belief among its members. In fact, the life of most isolated hunter-gatherer groups that have been studied appears to have revolved around religious rituals. In many of these groups, shamans held a very high social status, and strongly influenced group decisions.
Finally, there is solid empirical evidence from human genetics and the study of modern human groups that: (a) “religiosity” may be coded into our genes, to a larger extent in some individuals than in others; and (b) those who are spiritual, particularly those who belong to a spiritual or religious group, have generally better health and experience lower levels of depression and stress (which likely influence health) than those who do not.
There was once an ape that became smart. It invented weapons, which greatly multiplied the potential for death and destruction of the ape’s natural propensity toward violence; violence often motivated by different religious and cultural beliefs held by different groups. It also invented delicious foods rich in refined carbohydrates and sugars, which slowly poisoned the ape’s body.
Could the recent invention of atheism have been just as unhealthy?
Surely religion has been at the source of conflicts that have caused much death and destruction. But is religion, or spirituality, really to be blamed? Many other factors can lead to a great deal of death and destruction, sometimes directly, other times indirectly – e.g., poverty and illiteracy.
Brown, D.E. (1991). Human universals. New York, NY: McGraw-Hill.
Chauvet, J.M., Deschamps, E.B., & Hillaire, C. (1996). Dawn of art: The Chauvet Cave. New York, NY: Harry N. Abrams.
De La Croix, H., Tansey, R.G., & Kirkpatrick, D. (1991). Gardner’s art through the ages: Ancient, medieval, and non-European art. Philadelphia, PA: Harcourt Brace.
Gombrich, E.H. (2006). The story of art. London, England: Pheidon Press.
Murdock, G.P. (1958). Outline of world cultures. New Haven, CN: Human Relations Area Files Press.
Thursday, May 20, 2010
A gentleman by the name of Bertram has translated/summarized my series on the causes and prevention of malocclusion (misaligned teeth) into German. His site is OriginalHealth.net, and you can find the first post here, with links to the subsequent 8. It looks like an interesting site-- I wish I could read German. Thanks Bertram!
During [the] cheese fermentation process the vitamin K2 (menaquinone) content of cheese is increased more than ten-fold. Vitamin K2 is anti-carcinogenic, reduces calcification of soft tissue (like arteries) and reduces bone fracture risk. So vitamin K2 in aged cheese provides major health benefits that are not present in the control nutrients. [Jack is referring to the control nutrients used in the study summarized in the previous post.]
Another apparent benefit of aged cheese is the breakdown of the peptide BCM7 (beta-casomorphin 7) which is present in the casein milk of most cows (a1 milk) in the U.S. BCM7 is a powerful oxidant and is highly atherogenic. (From "Devil in the Milk" by Keith Woodford.)
[P]asteurization is not necessary, for during the aging process, the production of lactic acid results in a drop in pH which destroys pathogenic bacteria but does not harm beneficial bacteria! Many benefits result.
In making aged cheese, the temperature [should] be kept to no more than 102 degrees F, the same temperature that the milk comes out of the cow. The many beneficial enzymes in milk (8 actually) therefore are not harmed and provide many health benefits. Lactoferrin, for example, destroys pathogenic bacteria by binding to iron (most pathogenic bacteria are iron loving) and also helps in absorption of iron. Lipase helps break down fats and reduces the load on the pancreas which produces lipase.
By federal law, milk that has not been pasteurized cannot be shipped across state lines [in the U.S.], but raw milk cheese can be legally shipped provided that it has been aged at least sixty days. Thus, in backward states like Alabama where I live that do not permit the sale of raw milk, you can get the same beneficial enzymes (well, almost) from aged cheese as from raw milk. And as you pointed out, cheese that is shrink-wrapped will keep a long time and can be easily shipped.
I buy most of my raw milk cheese from a small dairy in Elberta, Alabama, Sweet Home Farm, which produces a great variety of organic raw milk cheese from Guernsey cows that are fed nothing but grass. No grain, no antibiotics or growth hormones. There is nothing comparable in the way of milk that is available legally. The so called “organic” milk sold in stores is all ultra-pasteurized. Yuck.
Raw milk cheese is readily shipped. Sweet Home Farm does not ship cheese, so I have to go get it, 70 miles round trip. On occasion I buy raw milk cheese from Next Generation Dairy, a small coop in Minn. which promises that they do not raise the temperature of the cheese to more than 102 degrees F during manufacture. The cheese is modestly priced and can be shipped inexpensively.
Tuesday, May 18, 2010
- The little known causes of the obesity epidemic
- Why the common weight loss advice to “eat less and exercise more” isn’t effective
- The long-term results of various weight loss diets (low-carb, low-fat, etc.)
- The body-fat setpoint and its relevance to weight regulation
- The importance of gut flora in weight regulation
- The role of industrial seed oils in the obesity epidemic
- Obesity as immunological and inflammatory disease
- Strategies for preventing weight gain and promoting weight loss
One reasonably reliable way of differentiating between traditional and processed cheese varieties is to look for holes. Cheese-making bacteria produce a gas, carbon dioxide, which leaves holes in cheese. There are exceptions though, and sometimes the holes are very small, giving the impression of no holes. Another good way is to look at the label and the price; usually processed cheese is labeled as such, and is cheaper than traditionally made cheese.
Cheese does not normally spoil; it ages. When vacuum-wrapped, cheese is essentially in “suspended animation”. After opening it, it is a good idea to store it in such a way as to allow it to “breathe”, or continue aging. Wax paper does a fine job at that. This property, extended aging, has made cheese a very useful source of nutrition for travelers in ancient times. It was reportedly consumed in large quantities by Roman soldiers.
Walther and colleagues (2008) provide a good review of the role of cheese in nutrition and health. The full reference is at the end of this post. They point out empirical evidence that cheese, particularly that produced with Lactobacillus helveticus (e.g., Gouda and Swiss cheese), contributes to lowering blood pressure, stimulates growth and development of lean body tissues (e.g., muscle), and has anti-carcinogenic properties.
The health-promoting effects of cheese were also reviewed by Higurashi and colleagues (2007), who hypothesized that those effects may be in part due to the intermediate positive effects of cheese on adiponectin and visceral body fat levels. They conducted a study with rats that supports those hypotheses.
In the study, they fed two groups of rats an isocaloric diet with 20 percent of fat, 20 percent of protein, and 60 percent of carbohydrate (in the form of sucrose). In one group, the treatment group, Gouda cheese (produced with Lactobacillus helveticus) was the main source of protein. In the other group, the control group, isolated casein was the main source of protein. The researchers were careful to avoid confounding variables; e.g., they adjusted the vitamin and mineral intake in the groups so as to match them.
The table below (click to enlarge) shows initial and final body weight, liver weight, and abdominal fat for both groups of rats. As you can see, the rats more than quadrupled in weight by the end of the 8-weight experiment! Abdominal fat was lower in the cheese group; one type of visceral fat, mesenteric, was significantly lower. Whole body weight-adjusted liver weight was higher in the cheese group. Liver weight increase is often associated with increased muscle mass. The rats in the cheese group were a little heavier on average, even though they had less abdominal fat.
The figure below shows adiponectin levels at the 4-week and 8-week marks. While adiponectin levels decreased in both groups, which was to be expected given the massive gain in weight (and probably body fat mass), only in the casein group the decrease in adiponectin was significant. In fact, the relatively small decrease in the cheese group is a bit surprising given the increase in weight observed.
If we could extrapolate these findings to humans, and this is a big “if”, one could argue that cheese has some significant health-promoting effects. There is one small problem with this study though. To ensure that the rats consumed the same number of calories, the rats in the casein group were fed slightly more sucrose. The difference was very small though; arguably not enough to explain the final outcomes.
This study is interesting because the main protein in cheese is actually casein, and also because casein powders are often favored by those wanting to put on muscle as part of a weight training program. This study suggests that the cheese-ripening process induced by Lactobacillus helveticus may yield compounds that are particularly health-promoting in three main ways – maintaining adiponectin levels; possibly increasing muscle mass; and reducing visceral fat gain, even in the presence of significant weight gain. In humans, reduced circulating adiponectin and increased visceral fat are strongly associated with the metabolic syndrome.
One caveat: if you think that eating cheese may help wipe out that stubborn abdominal fat, think again. This is a topic for another post. But, briefly, this study suggests that cheese consumption may help reduce visceral fat. Visceral fat, however, is generally fairly easy to mobilize (i.e., burn); much easier than the stubborn subcutaneous body fat that accumulates in the lower abdomen of middle-aged men and women. In middle-aged women, stubborn subcutaneous fat also accumulates in the hips and thighs.
Could eating Gouda cheese, together with other interventions (e.g., exercise), become a new weapon against the metabolic syndrome?
Higurashi, S., Kunieda, Y., Matsuyama, H., & Kawakami, H. (2007). Effect of cheese consumption on the accumulation of abdominal adipose and decrease in serum adiponectin levels in rats fed a calorie dense diet. International Dairy Journal, 17(10), 1224–1231.
Walther, B., Schmid, A., Sieber, R., & Wehrmüller, K. (2008). Cheese in nutrition and health. Dairy Science Technology, 88(4), 389-405.
Is Chiropractic Care a Visionary Form of Health-Care Reform?
If you’ve ever complained of a terrifically sore neck or lingering back pain, I’ll bet someone suggested that you see a chiropractor. I visit my chiropractor when my recurrent neck pain flares up (as in, when I spend too many hours in front of my computer for too many days in a row), and I know lots of other people who see chiropractors, too. Now research is affirming the efficacy of chiropractic care for a number of conditions, and this trend may be further stoked by changes brought about by health-care reform.
For many complaints, including such varied and seemingly unrelated ones as headaches and digestive distress as well as back and neck problems, chiropractic care can often provide safe, effective and fast-working treatment -- and (unusual for natural therapies) most insurance plans cover it. However, many mainstream medical doctors aren’t fans. Their reasons aren’t always clear but seem to lie somewhere on the spectrum between being worried that chiropractic care is not safe and feeling threatened that good chiropractors may take away many of their patients.
The Time is Right
In a glass-is-half-full kind of way, today’s troubled health-care environment actually presents an opportunity for chiropractors to gain some long overdue respect -- at least that’s a hope that’s currently afloat in the chiropractic community, I heard from Robert A. Hayden, DC, PhD, spokesperson for the American Chiropractic Association. A critical-care nurse for 20 years before becoming a chiropractor himself, Dr. Hayden explained that the nation’s ongoing and pressing concern about health-care costs and treatment efficacy is a good backdrop against which to understand the many ways chiropractic care can help patients.
Why are doctors skeptical? Dr. Hayden told me that one of his regular patients is an orthopedic surgeon -- but another orthopedist in his community won’t accept patient referrals from Dr. Hayden, and a nearby hospital won’t perform MRI scans for his patients. He believes this lack of acceptance is fueled by the very fact that chiropractic does not involve drugs and can be an effective alternative to hospitalization and surgery, which makes it attractive to both patients and the bean counters of health-care costs. The fact that Medicare now covers some chiropractic services enhances its credibility but also adds weight to worries that this natural, less invasive and less expensive alternative will divert health-care dollars away from medical doctors and hospitals.
What Will It Take?
Key to the growing acceptance of chiropractic care is evidence-based research demonstrating that it is safe, clinically effective and cost-efficient. In the latest such effort, funded by Mercer Health and Benefits in San Francisco, Dr. Niteesh Choudry and colleagues reviewed existing literature on the efficacy of chiropractic. Their conclusion is that it works as well as or better than conventional modalities, including exercise programs, drug regimens and surgical intervention, for treating many forms of low back and neck pain, two of the most common medical complaints. Numerous other studies also support the effectiveness of chiropractic treatment for spine and neck issues in particular. For instance, a 2002 study of patients with nonspecific neck pain found that pain was reduced and function improved for 68.3% after seven weeks of chiropractic care, while the success rate for those in the care of general practitioners was only 36%. The patients of chiropractors missed work less frequently and needed less pain medication.
Can It Cause Stroke?
One very specific concern voiced by many medical doctors is that chiropractic neck manipulation has the potential to cause stroke, or -- if done improperly -- even death. The basis for this is a fairly rare and often undiagnosed condition in which the vertebral arteries in the neck are weakened, possibly by high levels of homocysteine. The fear is that in a vulnerable patient, twisting or stretching those arteries during a chiropractic manipulation could cause them to rupture.
To investigate whether this is a real danger, researchers at the University of Calgary (Alberta, Canada) studied vertebral arteries from several recently deceased people and found that it would take nine times the force of a typical chiropractic adjustment to damage these arteries and mobilize plaque. In fact, according to Dr. Hayden, normal head and neck movement present a greater risk than chiropractic manipulation for the kind of weak arteries that are of concern. By that measure, it’s risky to have your hair washed in one of those beauty parlor sinks where you have to lean way back (there’s even a name for this one, "the beauty parlor stroke"), play sports or even to turn your head to complete a turn while driving.
The condition that puts people at risk for this problem is very rare, Dr. Hayden said, noting that the statistics don’t support the level of concern being expressed. He pointed out that chiropractic is so low-risk that practitioners’ malpractice insurance costs only about one-tenth what an MD has to pay -- around $1,300, on average, compared with $10,000 to $20,000 for general physicians.
The Trend Is Good...
Meanwhile though, patients are voting with their feet -- so maybe doctors should try to learn more about chiropractic care rather than stand in the way of progress. The number of chiropractic patients in this country doubled in the two decades from 1982 to 2002, and an estimated 10% of Americans have seen a chiropractor in the past year.
As for me, well, when my neck hurts, I visit my chiropractor... and I feel better. If you’re interested in exploring this form of alternative medical care, you can go to http://www.acatoday.org/search/memsearch.cfm to find an experienced, licensed practitioner in your area.
Robert A. Hayden, DC, PhD, founder and director of Iris City Chiropractic Center, PC, Griffin, Georgia, and spokesperson for the American Chiropractic Association.
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